Piperacillin

Mechanism :

It is a semisynthetic extended spectrum penicillin effective against the gram-negative organisms like Pseudomonas and Klebsiella species. It has a spectrum similar to mezlocillin. It is primarily used in patients with ticarcillin –resistant pseudomonas infection.

Indication :

Bacterial infections:
Bone and joint infection
Complicated appendicitis
GI infections
Gonorrhoea
Meningitis
Respiratory tract infections
Septicemia
UTI

Contraindications :

Allergic to any ingredient in piperacillin/tazobactam.

History of allergic reaction to any penicillin (e.g., amoxicillin), cephalosporin (e.g., cephalexin), or beta-lactamase inhibitor (e.g., clavulanic acid)

Dosing :

Neonates <30 weeks postmenstrual age:

100 mg/kg/dose (piperacillin component) IV every 8 hours.

Neonates >30 weeks postmenstrual age:

80 mg/kg/dose (piperacillin component) IV every 6 hours.

2 to 9 months:

80 mg/kg (piperacillin component) IV every 6 hours.

9 months or older:

<40 kg:

100 mg/kg (piperacillin component) IV every 8 hours.

>40 kg:

3.375 g IV over 30 mins every 6 hours; total dose of 13.5 g to be administered for 7-10 days.

Adverse Effect :

Diarrhea, constipation, insomnia, fever, headache, nausea, vomiting, eosinophilia (usually precedes piperacillin induced renal injury), serum sickness like reaction, hemolytic anemia, neutropenia, interstitial nephritis, hypokalemia, seizures, hyperbilirubinemia and raised liver enzymes.

Interaction :

Atracurium: The agent increases the effect of the muscle relaxant.
Demeclocycline: Possible antagonism of action.
Doxacurium Chloride: The agent increases the effect of the muscle relaxant.
Doxycycline: Possible antagonism of action.
Ethinyl Estradiol: This anti-infectious agent could decrease the effect of the oral contraceptive.
Mestranol: This anti-infectious agent could decrease the effect of the oral contraceptive.
Methacycline: Possible antagonism of action.
Methotrexate: The penicillin increases the effect and toxicity of methotrexate.
Metocurine: The agent increases the effect of the muscle relaxant.
Minocycline: Possible antagonism of action.
Mivacurium: The agent increases the effect of the muscle relaxant.
Oxytetracycline: Possible antagonism of action.
Pancuronium: The agent increases the effect of the muscle relaxant.
Pipecuronium: The agent increases the effect of the muscle relaxant.
Rocuronium: The agent increases the effect of the muscle relaxant.
Rolitetracycline: Possible antagonism of action.
Succinylcholine: The agent increases the effect of the muscle relaxant.
Tetracycline: Possible antagonism of action.
Tubocurarine: The agent increases the effect of the muscle relaxant.
Vecuronium: The agent increases the effect of the muscle relaxant.

Hepatic Dose :

No dosage adjustments are recommended.